System and method for management of pharmacy workflow

ABSTRACT

A system and method for optimized management of pharmacy workflow, specifically, workflow associated with fulfillment of prescription orders for medications and health-related products in a pharmacy environment. A computer-controlled system coordinates and controls pharmacy workflow to sequence prescriptions for fulfillment in a most efficient path thereby minimizing a cost function associated with fulfillment of the prescription order. The system coordinates and controls prescription order fulfillment from automated and non-automated storage locations and can be easily adapted to the specific layout and level of automation desired by the operator.

CROSS-REFERENCE TO RELATED PATENT APPLICATIONS

This is a divisional application of application Ser. No. 10/283,529,filed Oct. 30, 2002, which is incorporated herein by reference in itsentirety.

FIELD OF THE INVENTION

The present invention relates to management of work flow in a pharmacyenvironment. More particularly, the invention relates to a system andmethod for optimized fulfillment of prescription orders within thepharmacy.

BACKGROUND OF THE INVENTION

Pharmacies are an important source of medications and health-relatedproducts for a wide range of people including, for example, retailcustomers, hospitalized patients and residents of alternate site (e.g.,long term care) facilities. The pharmacy which serves the needs of suchpeople may be located for instance, in a retail environment, such as adrugstore, or a facility adjunct to the hospital or alternate sitefacility. A typical pharmacy is staffed by at least one registeredpharmacist and is further staffed by trained pharmacy technicians andclerks.

Pharmacy personnel provide a broad range of services and information.For example, the pharmacist typically has overall responsibility forensuring that all prescription orders for medications and health-relatedproducts are fulfilled properly. The pharmacy technicians may assist thepharmacist in fulfillment of the prescription orders and inreplenishment of the medication inventory. Pharmacists and pharmacytechnicians commonly provide other important service such as interactionwith customers, doctors and care givers, the provision of health-relatedadvice, data entry and processing of medical and financial informationadjunct to fulfillment of the prescription orders. Provision of adviceand information may include direct interaction with others while dataprocessing and order fulfillment typically involve interaction betweenthe pharmacy personnel and a computer or with the medications andproducts needed to fulfill the prescription orders. For example,fulfillment of the prescription orders may involve locating one or moremedications or products at a static storage shelf or other storagelocation, dispensing a quantity of the medications or products requiredto fill each prescription comprising the order, manually packaging themedications in containers (such as bottles and vials) and dispensing thepackaged medications and products to the customer, doctor or care giver.

It is highly desirable for the pharmacist and pharmacy technicianpersonnel to be available to provide high value added services, such asproviding health-related advice and information to customers, doctorsand care givers. It is also desirable to fulfill each prescription orderin terms of the lowest possible cost function. Such cost function may bedefined in terms of many variables, such as the total time required tofulfill each prescription order, the spacial distance traveled by thepharmacy personnel within the pharmacy in order to fulfill eachprescription order and the cost to the pharmacy of the medication andproducts used to fulfill each prescription order. The cost function mayalso be defined in terms of cost reduction through coordination of thefulfillment of co-pending prescription orders. A further criticalrequirement of the pharmacy is the need for accuracy and error avoidancein the fulfillment of the prescription orders.

To these and other ends, there has been a growing use and acceptance ofautomation in connection with fulfillment of prescription orders bypharmacies. Such automation can include the use of computerizedinformation databases for processing medical and financial information,the use of automated apparatus for dispensing medications and articlesand the use of machine-readable code (e.g., bar coding) for purposes ofensuring accuracy in fulfillment of the prescription orders and inmaintaining inventory. Any improvement in pharmacy efficiency may resultin an overall better level of service to the customer, doctor or caregiver.

A major problem confronting the use of automation in the pharmacyenvironment is the legitimate need for human beings to participate inthe prescription order fulfillment process. Pharmacy personnel arerequired to make many complex decisions and to undertake many tasks tofulfill the prescription orders in an efficient manner. Judgments mustbe made, for example, as to the medications and products best suited tothe customer's needs and the most efficient path by which to locate,obtain, package and dispense the contents of each prescription order,and to do this in a manner which minimizes the potential for error.Moreover, human beings require time to fulfill the prescription ordersincluding the time required to move spatially within the pharmacy fromstorage location to storage location. In fact, it has been demonstratedthat a pharmacy employee may walk as much as five miles throughout thepharmacy during the course of a typical work week; this represents atime component which contributes to the cost function associated withfulfillment of the prescription orders. Consequently, the use ofpharmacy automation must coordinate human and machine resources tofulfill each prescription order at the lowest cost function with thehighest possible level of error avoidance.

While there are a number of pharmacy automation systems and productsdescribed in the art, those systems and products do not disclose systemsfor optimized management of workflow associated with fulfillment of theprescription orders. For example, U.S. Pat. No. 5,597,995 (Williams etal.) describes a prescription fulfillment system which requires imaging,filling and checking work stations. Medication is dispensed intocontainers at the filling work station from a collection of automateddispenser apparatus or from static storage locations. While certainefficiencies are derived from use of automated dispenser apparatus, the'995 patent fails to describe any coordinated and optimized use of thesystem components to select medications with the lowest cost functionand fail to disclose any procedure or apparatus to efficiently sequencethe prescriptions comprising fulfillment of the prescription ordersthereby optimally reducing the cost function associated with thefulfillment process.

U.S. Pat. No. 5,907,493 (Boyer et al.) describes a pharmaceuticaldispensing system for filling prescriptions in a pharmacy setting. Acentral computer controls a plurality of pill dispensing cells each ofwhich are stated to include helical singulation apparatus each under thecontrol of a separate microprocessor. Medications may also be stored fordispensing at shelf locations. While the central computer is stated tostore information regarding a plurality of drugs in predetermined,separately-addressable cells and to arrange that information to provideoptimum efficiency of pharmaceutical operations, such assertion ofefficiency does not include any coordinated and optimized use of thesystem components to select optimized medications for each prescriptionand then sequence filling of the prescription so as to optimally reducethe cost function associated with the prescription order fulfillmentprocess.

An automated pharmacy is described in U.S. Pat. No. 6,202,923 (Boyer etal.). The pharmacy described therein is said to have improved pharmacythroughput because the labels to be affixed to the medication containersare generated once the specified prescription is displayed at a fillingworkstation thereby avoiding any requirement to manually transfer labelsfrom an upstream data entry workstation. Unfortunately, workflow in theautomated pharmacy is not fully optimized because, once again, there isno provision for any optimized sequencing of the prescriptionscomprising the prescription order to reduce the cost function associatedwith the prescription order fulfillment process.

U.S. Pat. No. 6,181,979 (Murakami) discusses a drug preparation system.Data are collected to determine the throughput times of particular drugprocessing and throughput stations within the system. The information isused to allocate pharmacy personnel to the various drug processing andinspection stations but is not utilized to determine an optimum sequenceof prescriptions within an order.

It would be significant improvement in the art to provide an improvedpharmacy automation system and method of pharmacy workflow managementwhich would optimally reduce the cost function associated withfulfillment of prescription orders, which would reduce the potential forerrors in the fulfillment process, which would be operable to controlvirtually any type of dispensing and storage apparatus, which would beadaptable for use in many different pharmacy environments, including forexample, retail pharmacies, alternate site facilities, hospitals andlike facilities, and which would free pharmacists and pharmacytechnicians to perform high value added services thereby better servingthe customers, doctors and care givers reliant on the pharmacy.

OBJECTS OF THE INVENTION

It is an object of the invention to provide an improved pharmacyautomation system and method of pharmacy workflow management overcomingsome of the problems and shortcomings of the prior art, including thosereferred to above.

Another object of the invention is to provide an improved pharmacyautomation system and method of pharmacy workflow management which wouldreduce the cost function associated with fulfillment of prescriptionorders to an extent not capable of being provided by existing pharmacyautomation systems.

An object of the invention is to provide an improved pharmacy automationsystem and method of pharmacy workflow management which is simple toutilize in the pharmacy environment.

Still another object of the invention is to provide an improved pharmacyautomation system and method of pharmacy workflow management which wouldminimize the need for human involvement in the prescription orderfulfillment process.

Yet another object of the invention is to provide an improved pharmacyautomation system and method of pharmacy workflow management which wouldreduce the amount of time required to fulfill a prescription order.

It is also an object of the invention to provide an improved pharmacyautomation system and method of pharmacy workflow management which wouldreduce the spacial distance required to be traveled to fulfill aprescription order.

It is an object of the invention to provide an improved pharmacyautomation system and method of pharmacy workflow management whichreduces the potential for errors in the fulfillment process.

Another object of the invention is to provide an improved pharmacyautomation system and method of pharmacy workflow management which isadaptable for use with a range of pharmacy environments.

A further object of the invention is to provide an improved pharmacyautomation system and method of pharmacy workflow management which isadaptable for use with any filling or storage apparatus within thepharmacy.

One additional objective of the invention is to free pharmacy personnelfor better service to the pharmacy customers, doctors and care givers.

How these and other objects are accomplished will become apparent fromthe following descriptions and the drawings.

SUMMARY OF THE INVENTION

In general, the invention is a workflow management system (“WMS”) andmethod for optimized management of pharmacy workflow, specifically,workflow associated with fulfillment of prescription orders formedications and health-related products in a personnel-driven pharmacyoperation. (As used herein, the term “medication” is intended to be abroad term including medications as well as health-related productstypical of those provided by pharmacies.) Each prescription orderfulfilled by the pharmacy includes one or more prescriptions. Themedications accessed to fulfill the prescriptions comprising eachprescription order may be located at automated and/or non-automatedmedication storage locations organized into “fulfillment centers” andpositioned about the pharmacy.

The WMS coordinates and controls prescription order fulfillment byorganizing fulfillment of the prescriptions in the most efficientworkflow path and then by directing the pharmacy personnel to andbetween the fulfillment center automated and/or non-automated medicationstorage locations to retrieve the required medications, also in the mostefficient workflow path. The WMS is intended to make the task of thepharmacy personnel easier and more reliable, thereby providing a higherlevel of service to the customer. Therefore, the present invention isintended for use in personnel-driven pharmacies where direct humaninvolvement is required to fulfill the prescriptions in the prescriptionorder, and does not relate to fully mechanized and automated facilities,which are outside the scope of the invention.

The invention includes a computer-controlled system of pharmacymanagement which coordinates fulfillment of each prescription orderbased on the pharmacy layout and storage location of the medicationrequired to fulfill each prescription within the prescription order. TheWMS determines the optimal sequence for fulfillment of each prescriptionwithin a prescription order and places the prescriptions within aprescription sequence to minimize the cost function associated withfilling the prescription order.

The cost function is established by means of rules which may bedeveloped based on the requirements of the pharmacy operator. Mostcommonly, those rules will seek to minimize the monetary cost or timerequired to fill a prescription order. However, other rules may bedeveloped including, for example: (1) rules for reduction of thedistance traveled to fulfill a prescription order; (2) rules forreduction of time and distance required to fulfill a prescription order;and (3) rules for reduction of time required to fulfill co-pendingprescription orders based on sequenced utilization of the storagelocations required for fulfillment of the co-pending prescriptionorders.

The improvements in efficiency made possible by the invention freevaluable pharmacy personnel to perform value added functions such asproviding advise and guidance to customers and health care providers.Moreover, the system increases pharmacy throughput and reduces thepotential for error further improving pharmacy work flow.

In one embodiment, the WMS for optimized management of workflowassociated with fulfillment of medication prescription orders includes aplurality of spaced-apart medication storage locations. Preferably, thestorage locations are at fulfillment centers and include automatedand/or non-automated dispenser and storage apparatus. However, theprecise apparatus selected for the storage locations will be tailored tothe needs of the particular pharmacy operator. The system furtherincludes a medication inventory including plural medications stored atpredetermined storage locations within the system.

A control computer is provided, preferably as part of a local areanetwork, to receive prescription orders from a host pharmacy informationsystem into a prescription order database. The control computer includesprogrammed instructions adapted to optimize the pharmacy workflowassociated with fulfillment of the prescription orders includinginstructions for management of the medication inventory database andprescription order data base and to minimize the cost functionassociated with fulfillment of the prescription orders stored in theprescription order database. The programmed instructions enable: (1) foreach prescription within the prescription order, selection of themedication storage location from which to obtain the medication requiredto fulfill the prescription; and (2) for each prescription order,determination of a prescription sequence corresponding to the sequencein which each prescription is fulfilled, first to last, within theprescription order.

Once the sequence is determined, the control computer utilizesprogrammed instructions to permit the system to present inhuman-readable form (for each prescription order), the prescriptionsequence and the storage location of the medication comprising eachsequenced prescription, and generate a print_label command followingobtaining of each sequenced prescription. The print_label command isreceived by a label printer electronically connected to the controlcomputer causing the label printer to print a label includingprescription information and machine-readable indicia for each sequencedprescription. The label is of a type adapted for application to acontainer for each prescription within the prescription order.

The prescription sequence may be visually presented on a display devicelocated at a work station in the pharmacy. More than one work stationmay be provided. An input device at the work station permits thepharmacist or filling technician to select each of the sequencedprescriptions for fulfillment. Preferably, the prescription sequencepresented includes, for each sequenced prescription: text information;medication image information; and an icon representing each storagelocation corresponding to the sequenced prescription.

Preferably, a sequence sheet is provided as an aid to the pharmacypersonnel in fulfilling the prescription order. The prescriptionsequence is printed at the pharmacy and includes the prescriptionsequence printed thereon including the machine-readable indicia for eachsequenced prescription. The sequence sheet may then be manually carriedto each storage location as directed by the prescription sequence.

Preferably, the print_label command used to initiate printing of thelabel is generated in response to agreement between an initiate_dispensesignal and a medication dispensed signal. The initiate_dispense signalis triggered by an input device, such as a touch screen display, barcode scanner, mouse or keyboard, before obtaining each prescription inthe order. The medication_dispensed signal is generated during or afterobtaining each prescription in the order, for example by the automateddispenser or by manually scanning a bar code on the package containingthe medication.

It is very highly preferred that at least one of the WMS work stationsincludes a computer for validation of the prescription order beforerelease to a customer. The computer is electronically connected to thecontrol computer and the input device for that computer includes, atleast, a reader device electronically connected to the workstationcomputer. The preprogrammed instructions for validating eachprescription order at the work station include instructions adapted to:(1) receive a first validation signal generated by selecting, with theinput device, a prescription from the prescription sequence presented onthe display device; (2) receive a second validation signal generated byreading, with the reader device, the machine-readable indicia on thelabel applied to the container corresponding to each selectedprescription; (3) determine agreement between the first and secondvalidation signals; and (4) release the prescription order afteragreement for each prescription is determined.

The invention may include a replenishment process managed by the WMS.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic diagram showing a top plan view of a conventionalpharmacy.

FIG. 2 is a schematic diagram showing a top plan view of a pharmacyincluding a pharmacy workflow management system according to theinvention.

FIG. 2A is a schematic diagram of exemplary medication storage locationstaken along section 2A-2A of FIG. 2.

FIG. 3 is a schematic diagram showing a side elevation of components ofthe system of FIG. 2 taken along section 3-3 of FIG. 2.

FIG. 3A is a schematic diagram showing a side elevation view taken alongsection 3A-3A of FIG. 3.

FIG. 3B is a schematic diagram showing a side elevation view taken alongsection 3B-3B of FIG. 3.

FIG. 3C is a schematic diagram showing a side elevation view taken alongsection 3C-3C of FIG. 3.

FIG. 3D is a schematic diagram showing a side elevation view taken alongsection 3D-3D of FIG. 3 showing a representative medication storagelocation.

FIG. 4 is schematic diagram showing a top plan view of a furtherembodiment of a pharmacy including a pharmacy workflow management systemaccording to the invention.

FIG. 4A is a schematic diagram of exemplary medication storage locationstaken along section 4A-4A of FIG. 4.

FIG. 5 is a schematic diagram of an exemplary computer network useful inpracticing the pharmacy workflow management system according to theinvention.

FIGS. 6A-6D are container labels provided in accordance with theinvention.

FIGS. 7A-7D are containers useful in practicing the pharmacy workflowmanagement system according to the invention.

FIG. 7E is an exemplary cassette useful for storing bulk-formmedications for dispensing by automated dispenser apparatus.

FIG. 8 is a sequence sheet in the form of a tote bag.

FIGS. 9A-9D provide a flow diagram describing a method of pharmacyworkflow management according to the invention.

FIG. 10 is a front view of a video display screen image showingprescription orders pending with the system according to the invention.

FIG. 11 is a front view of the screen image of FIG. 10 showing that theorder for Mr. Gibson has been processed by the system according to theinvention. The four prescriptions comprising Mr. Gibson's prescriptionorder are presented in a sequence determined to optimize fulfillment andreduce the cost function.

FIG. 12 is a front view of a screen image showing two prescriptionsawaiting fulfillment by automated dispenser apparatus at a fulfillmentcenter.

FIG. 13 is a front view of the screen image showing the pendingprescriptions of FIG. 12 immediately prior to fulfillment of the firstpending prescription, but in a paperless mode.

FIG. 14 is a front view of the screen image of FIG. 12 followingfulfillment of the first prescription and immediately prior tofulfillment of the second prescription.

FIG. 15 is a front view of the screen image showing the second pendingprescription of FIG. 14 immediately prior to fulfillment of such secondprescription, but in a paperless mode.

FIG. 16 is a front view of a screen display showing one prescriptionawaiting fulfillment by manual retrieval from a non-automated, manualshelf location.

FIG. 17 is a front view of the screen image showing the pendingprescription of FIG. 16 immediately prior to fulfillment of suchprescription, but in a paperless mode.

FIG. 18 is a front view of the screen image of FIG. 17 but showing anoptional touch screen panel for confirming fulfillment of the pendingprescription.

FIG. 19 is a front view of a screen image showing one prescriptionawaiting fulfillment by an automated unit-of-use dispenser apparatus.

FIG. 20 is a front view of the screen image showing the pendingprescription of FIG. 19 immediately prior to fulfillment of suchprescription, but in a paperless mode.

FIG. 21 is a front view of the screen image of FIG. 19 but showing anoptional touch screen panel for confirming fulfillment of pendingprescription.

FIG. 22 is a front view of a screen image showing the four filledprescriptions comprising the prescription order prior to validation ofthe prescription order by the pharmacist. Reference images of the fourmedications comprising the prescription order are provided.

FIG. 23 is a front view of the screen image of FIG. 22 subsequent toinitiation of validation by the pharmacist.

FIG. 24 is a front view of the screen image of FIG. 23 but afterselection of the first prescription for validation. An enlarged stockimage of the associated medication is provided.

FIG. 25 is a front view of the screen image of FIG. 24 but showingfurther enlargement of the stock image of the medication.

FIG. 26 is a front view of the screen image of FIG. 24 but followingvalidation of the first prescription.

FIG. 27 is a front view of the screen image of FIG. 24 followingvalidation of the entire prescription order. An enlarged reference imageof the fourth prescription is provided. The order is ready to bereleased to the customer.

FIG. 28 is a front view of a screen display showing the four filledprescriptions comprising the prescription order in the state where priorverification has not been undertaken. Reference images of the fourmedications comprising the prescription order are provided.

FIG. 29 is a front view of a screen display showing system set upcommands.

FIG. 30 is a front view of a further screen display showing additionalsystem set up commands including selection commands for automatic andmanual modes.

FIG. 31 is a hand held computer useful for practicing a replenishmentmethod according to the invention.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

The pharmacy workflow management system 1 (“WMS”) of the invention willfirst be described with respect to the exemplary pharmacy layoutsillustrated in FIGS. 1-4. FIG. 1 represents the layout of a conventionalpharmacy 3 while FIGS. 2-3 illustrate the layout of an improved pharmacy5 according to the invention, including automated and non-automated(i.e., manual) dispensing apparatus as described in detail below. FIG. 4shows a further improved pharmacy 7 according to the invention providedto demonstrate that the invention is highly adaptable for use with avariety of automated and non-automated dispenser apparatus. Eachpharmacy 5, 7 shown in FIGS. 2-4 can be located in any environmentwherein medications and products are dispensed in order to fillprescription orders and wherein direct human intervention in theorder-filling process is required. Thus, the term “pharmacy” is intendedto include diverse environments including retail pharmacies, pharmaciesin alternate site facilities, hospital pharmacies and the like.

Referring now to FIG. 1, the conventional pharmacy 3 shown thereinincludes an order entry workstation 9, a filling/checking workstation11, a payment workstation 13 and a consultation workstation 15.Conventional pharmacy 3 is provided with any number of non-automatedstorage locations at which medications and products are stored foraccess by pharmacy personnel. For example, the pharmacy 3 shown in FIG.1 is provided with an array of six static storage shelf units 17. Eachstorage shelf unit within the array 17 is typically about 6 to 8 feet inheight and includes a plurality of spaced-apart horizontally-orientedshelves. Medications and products are stored on each shelf within thearray 17 pending manual retrieval for fulfillment of a prescriptionorder.

Pharmacy 3 may include other storage locations such as arestricted-access cabinet 19 for storage of narcotics and othercontrolled medications. Pharmacy 3 may also include a refrigerator 21for storage of perishable medications and articles.

Pharmacy 3 is staffed by personnel having varying levels ofresponsibility. The pharmacy staff includes at least one registeredpharmacist 23, 25. Each pharmacist (e.g., pharmacist 23) is responsiblefor fulfillment of prescription orders and for verification of eachprescription order before the order is provided to a customer 27-35. Oneor more filling technicians 37, 39 may be employed to assist pharmacists23, 25 in fulfilling each prescription order. The pharmacists 23, 25 orfilling technicians 37, 39 may also provide health-care-relatedinformation to a customer 31 at consultation station 15.

A data entry clerk 41 is provided to supply prescription orderinformation to a host computer and pharmacy information system (notshown) via computer terminal 43 or 45 at data entry station 9. A salesclerk 47 processes sales transaction at the payment workstation 13 usingcomputer terminal 14 or 16.

Workflow at conventional pharmacy 3 may be summarized in the followingmanner. Data entry clerk 41 may input the prescription order informationto the system at data entry workstation 9 using keyboard 49 or computermouse 51 of computer 43. Following adjudication by the pharmacyinformation system, each adjudicated order is held in a database onpharmacy computer 53 at filling/checking workstation 11 for fulfillment,typically on a first in first out (“FIFO”) basis. Labels for attachmentto each container associated with the prescription order may be printedon printer 55.

Pharmacist 23, 25 or filling technician 37, 39 selects the prescriptionorder next in line to be filled. The prescription order, andprescriptions comprising the order, may be displayed on video display 57associated with computer 53. The prescriptions making up theprescription orders are not arranged in any particular sequence.

The pharmacist 23, 25 or filling technician 37, 39 then fills eachprescription in the prescription order. Each prescription in theprescription order is filled by walking to one of the storage locations17-21 and retrieving the appropriate medication which may be inbulk-form or in prepackaged form. The medication is then taken from thestorage location 17-21 to the filling/checking work station 11 where theappropriate number of medications are metered into a container, such asvial 59 with reclosable cap 61 (FIG. 7A), in accordance with theprescription order. The corresponding label is placed on each container(e.g., vial 59).

This process is repeated until each prescription in the prescriptionorder is fulfilled. The prescription order is then verified bypharmacist 23, 25 at filling/checking work station 11 to ensure that thecorrect medication is in each container (e.g., vial 59). The fulfilledorder is then placed in a bag or other package and is held at a “willcall” area 63 near payment work station 13. Sales clerk 47 processes thetransaction and delivers the packaged prescription order to customer 33at the payment work station 13.

There are a number of problems associated with conventional pharmacy 3shown in FIG. 1 and described above. For example, conventional pharmacy3 requires excessive amounts of time and spacial travel to accessmedications stored at the spaced apart storage locations 17-21. Thepharmacist 23, 25 or filling technician 37, 39 must repetitively walkback and forth between storage locations 17-21 and filling/checking workstation 11. In a busy pharmacy 3 this can amount to many miles ofwalking during a 40 hour work week. While known automation technologycould be added to pharmacy 3 to facilitate dispensing of medications andproducts and improve accuracy of fulfillment, there is no process fororganizing prescription order work flow so as to direct pharmacypersonnel toward fulfillment of the prescription orders according to aminimized cost function. Therefore, there are opportunities forimprovement of the pharmacy 3.

Referring next to FIGS. 2-5, there are shown pharmacies 5, 7 includingthe WMS 1 according to the invention. As will be explained in detailbelow, pharmacies 5, 7 are configured for improved management ofprescription order fulfillment workflow. Pharmacies 5, 7 include manyidentical components and for purposes of convenience and brevity,identical reference numbers will be utilized to describe and identifythese like components. Pharmacy 7 differs from pharmacy 5 primarily inthat such pharmacy 7 is intended to fill a greater number ofprescription orders per unit time (i.e., has a greater throughput) thanthe pharmacy 5 of FIGS. 2-3.

It should be understood that the pharmacies 5, 7 are exemplary. Apharmacy according to the invention may be scaled and tailored to meetthe demands of the pharmacy operator. Thus, the WMS 1 may be adapted foruse in retail, hospital and alternate site environments and suchadaptability is an advantage of the invention.

As shown in FIG. 5, each pharmacy 5, 7 includes a local area network(“LAN”) 65 which interfaces with a host computer 67 and pharmacyinformation system (“PIS”) 69 and a number of designated areas at whichpharmacy activities are carried out. FIG. 5 shows an exemplary LAN 65for use in one embodiment of the invention. LAN 65 and its componentsmay be adapted to meet the needs of particular pharmacy operators.

Pharmacies 5, 7 each include: an order entry point 71; one or morefulfillment centers 73-79 associated with medication storage locationsas described below; validation point 81; and pick-up point 83. Atechnician work center 85 is provided as a general work area and as theprimary area in which fulfillment of prescription orders is initiated.An optional consultation point 87 where advice and health-relatedinformation is provided may also be included as a part of pharmacies 5,7. A will-call area 89 is provided to hold fulfilled prescription ordersawaiting pick-up by the customer, health care worker or other designatedperson.

The novel fulfillment centers 73-79 will be described first followed bydiscussion of the interface of centers 73-79 with LAN 65 and otherelements of pharmacies 5, 7. The automated and manual storage locationsat which medications and products are stored and dispensed are organizedinto groups referred to herein as fulfillment centers 73-79. The numberof fulfillment centers 73-79 and the apparatus associated with each suchcenter may be adapted to meet the unique needs of each pharmacyoperator. Pharmacy 5 includes three fulfillment centers 73, 75 and 79.In the example shown, first fulfillment center 73 is provided todispense bulk-form medications via semi-automated dispensers 91, 93, 95and 97. Bulk-form medications are medications that are in a loose,flowable form suitable for dispensing in any required quantity. Suchmedications may be provided in many different shapes and sizes and aredispensed into containers such as vials 59, bottles 105 and unit dosagepackages 108 (FIGS. 7A-7D).

Dispensers 91, 93 are preferably FastFill® brand dispensers availablefrom AutoMed Technologies, Inc of Vernon Hills, Ill. Each FastFilldispenser 91, 93 dispenses from each of 64 bulk-form medication storagecassettes located within the dispenser. Dispensers 95, 97 are preferablyQuickFill®Plus and QuickFill® brand dispensers also available fromAutoMed Technologies. Dispenser 95 dispenses from six cassettes whiledispenser 97 dispenses from 1 bulk-form medication storage cassette. Allof the cassettes for dispensers 91-97 are interchangeable.

Cassettes 99-103 shown in FIGS. 3, 3C and 7E are exemplary of the typeof cassette useful with dispensers 91-97. Each cassette 99-103 isdesigned to store a single type of medication in bulk form and isdesigned to fit on a corresponding base located on or within thedispensers 91-97. FIG. 3C shows cassette 103 mounted for use onQuickFill dispenser 97. The medications are metered out from thecassette corresponding to the medication designated for the prescriptionand into a container, such as vial 59 or bottle 105 (with reclosable cap107). Each medication is dispensed into vial 59 or bottle 105 positionedin contact with a release gate (not shown) and below the appropriatedispenser spout, such as spout 109-113. Contact with the gate triggersthe medication_dispensed signal discussed below. Each cassette includesa code, such as a bar code 114 to facilitate location of each cassetteat a storage location.

Each cassette (e.g., cassettes 99-103) is associated with a uniquemedication storage location, either in dispensers 91-97 or at a storagelocation, such as shelves 115, 117, 119 utilized when the cassettes arenot positioned in or on the dispenser 91-97. Each storage location, forexample shelf locations 115-119, has a unique storage location for eachcassette (e.g., cassettes 99-103) represented by an address code ofwhich codes 121, 123 are representative (FIG. 3D). Codes 121, 123preferably include a machine-readable code, such as the bar codes 122,124 shown as part of codes 121, 123 to further identify each uniquestorage location.

As shown particularly in FIGS. 3 through 3D, fulfillment center 73 ofpharmacy 5 may optionally include additional work surfaces, shelves anddrawers. For example, pharmacy 5 may include work surfaces 125, 127 andany number of additional storage locations provided to store medicationsand products useful in conjunction with fulfillment of prescriptionorders. Overhead shelves 129, 131 may be provided above work surfaces125, 127. Large pull-out drawers, such as drawers 133, 135, pull-outfoot drawers, such as drawers 137, 139 and lower tray shelves, such asshelves 145, 147 may be provided beneath work surfaces 125, 127. Basecabinets 141, 143 supporting dispensers 91, 93 may also include storagelocations in the form of drawers, such as drawers 146, 147. Each ofthese storage locations has its own address code (not shown) to permitidentification of the medications stored in a predetermined manner atthe storage locations. If desired, the client computers 187-191 forfulfillment centers 73, 75 and 79 could be located in base cabinets 141,143.

Referring further to FIGS. 2-3, pharmacy 5 may also include a furtherfulfillment center 75 including pre-packaged form automated productdispenser 151. A suitable dispenser 151 is a QP300 dispenser availablefrom AutoMed Technologies. Pre-packaged form medications or products areproducts provided in the form of a pre-packed product, such asprepackaged product 153 shown in FIG. 7C or the CERTS container stockimage 318 shown in FIG. 27. The prepackaged product holds apre-determined quantity of a medication or product in a packaged form.Such a prepackaged product could include a wide range of articles andthings such as a one-month supply (i.e., 30 units) of a medication, aprepackaged syringe or a packaged roll of gauze bandage. Frequently,there are cost advantages associated with prepackaging of medicationsinto quantities commonly requested by customers such that it may be lessexpensive to fulfill a prescription order with a prepackaged medicationproduct rather than to perform the dispensing through use of bulk-formmedication dispensers at the pharmacy 5, 7. As discussed herein, WMS 1permits selective dispensing between like medications based on the leastexpensive form of the medication available. The QP300 dispenser storesapproximately 300 prepackaged articles at shelf locations within thedevice. The QP300 dispenses the designated prepackaged product (e.g.,prepackaged product 153) into a bin 155 so that the product can begrasped by the pharmacist 241 or filling technician 247 Each prepackagedproduct 153 includes machine-readable indicia 154 (FIG. 7C), such as abar code, and each storage location within the QP300 has a uniqueaddress associated with that location. The address may be in anysuitable form and may consist of a code (including a machine-readablebar code) such as codes 121, 122, 123, 124 shown in FIG. 3D with respectto shelf 115 or code 183 shown in FIGS. 2A, 4A.

Referring to FIG. 4, pharmacy 7 includes a fulfillment center 77 whichincorporates a QuickScript® brand automatic dispenser apparatus 159 inplace of the automatic dispensers 91-97 and 151 provided for use inconjunction with pharmacy 5. The QuickScript dispenser 129 is also aproduct of AutoMed Technologies.

The QuickScript dispenser 159 has a higher throughput than thedispensers 91-97 and 151 and may be configured to dispense bothbulk-form medications and prepackaged form medications. The canistersholding bulk-form medications (not shown) and prepackaged articles(e.g., prepackaged product 153) are positioned at unique storage shelflocations (not shown) within dispenser 159. Each storage shelf locationhas a unique address associated with it. The bulk-form medications aredispensed from the associated canister and are packaged into containerssuch as vial 59 or bottle 105 while the pre-packaged products (such asproduct 153) are stored in bins or at shelf locations (not shown) withindispenser 129. The address of each storage location may be in the formof a code 121, 122, 123, 124 shown by example in FIG. 3D with respect toshelf 115 or code 183 shown in FIGS. 2A, 4A.

Dispenser 159 is configured to automatically fulfill each prescriptionwithin a prescription order and then accumulate all medications andproducts pertaining to the prescription order in a single location, suchas accumulator bin 161. A feature of dispenser 159 is that it cancapture a digital image of the bulk-form medications after they areloaded into the container 59, 105 and before the associated cap 61, 107is placed onto the container. The image can then be compared to a stockimage 318 of the medication during validation as discussed in detailbelow. Stock image 318 is preferably held in a database associated withcomputer 209. Thereafter, the pharmacist or filling technician cancollect all packaged medications and articles pertaining to the entireprescription order from the bin 161 for subsequent validation beforebeing provided to the customer.

Pharmacies 5, 7 optionally include a further fulfillment center 79consisting of manually-accessed high density shelf locations 163, 165.Each shelf location 163, 165 includes a plurality of drawers, of whichdrawers 167, 169 and 171 are exemplary. Each drawer (e.g., drawers167-171) is mounted to slide outwardly from shelf locations 163, 165 asshown in FIGS. 2 and 4. Each drawer 167-171 optionally includesmedication storage locations in the form of a plurality of cells, suchas cells 173, 175 and 177 (FIGS. 2A, 4A). Each cell 173-177 is providedto store a medication or product, such as containers 179, 181 (FIGS. 2,2A, 4, 4A). Each cell 173-177 has a unique address and may include anidentification code 183. Code 183 may also include machine-readableindicia 184, 186, such as a bar code, to facilitate identification ofeach storage location.

Fulfillment center 79 of pharmacies 5, 7 may also include a static shelfunit 185 for storage of containers for bulk-form articles. Each staticshelf unit 185 may be of any suitable height and includes a plurality ofspaced apart horizontally-oriented shelves (not shown). The bulk-formmedications or articles may be arranged in any suitable manner withinshelf units 185. Refrigerator 240 for storage of perishable medicationsand articles may be provided at center 79. Further, a narcotic-productstorage cabinet 189 may also provide storage locations within center 79.The narcotic-product storage cabinet 189 is locked with access limitedto authorized personnel. As with each of the medication storagelocations at fulfillment centers 73-79, each of the storage locationswithin shelf unit 185, refrigerator 240 and cabinet 189 is provided witha unique address which may be designated with a code (including amachine-readable bar code), such as codes 121, 122, 123, 124, 183, 184.

Each fulfillment center 73-79 is electronically connected to LAN 65 asshown schematically in FIG. 5. Each interconnecting solid line betweenthe components of LAN 65 on FIG. 5 represents suitable electronicconnection between such components. The dashed line connectingfulfillment center 77 to LAN 65 represents that center 77 is shown aspart of pharmacy 7 and not pharmacy 5. In addition to one or moreautomated or manual storage locations, each fulfillment center includesa client computer, respectively designated by reference numbers 187,189, 191, 193. Each client computer 187-193 is provided with a videodisplay 195, and one or more input apparatus such as keyboard 196, amachine-readable code scanner 197, computer mouse 199 and touch screen201. Because of the flexibility in configuration offered by LAN 65, itis possible that one display 195 may serve more than one center 73-79.For instance, display 195 at fulfillment center 75 could also serve asthe display for fulfillment center 79. Each client computer 187-193 andassociated components 195-201 at each fulfillment center 73-79 controlspharmacy workflow at that location. The client computers 187-193 arelinked into the LAN 65 along with one or more printers, such as sequencesheet printer 203 and label printers 205.

The configuration of the overall system is, of course, dependent onwhether the preferred mode of operation is “paperless” or will utilize asequence sheet 269. Both from a perspective of convenience and fromincreased productivity, a system configured for paperless operationwould include a greater number of video displays 195 positionedconveniently at each fulfillment center about the pharmacy. Other inputdevices, such as keyboards 196, machine-readable code scanners 197 andcomputer mice 199 are provided. For configurations utilizing a sequencesheet 269 and for reasons of both productivity and convenience in such aconfiguration, it would be necessary to provide machine-readable codescanners 197 at each fulfillment center.

The architecture of the computer system responsible for management ofthe pharmacies 5, 7 will now be described, particularly with respect toFIG. 5. Each of the client computers 187-193 of pharmacies 5, 7 is partof LAN 65 which interfaces these client computers to control computer209. Client computers 211, 213 are located, respectively, at thetechnician work center 85 and the validation point 81. Computers 211,213 include one or more input apparatus identical to computers 187-193including a keyboard 196, a machine-readable code scanner 197, computermouse 199 and touch screen 201. Client computers 187-193 are located,respectively, at or near fulfillment centers 73-79.

Control computer 209 is interfaced with host computer 67 of PIS 69. Hostcomputer 67 is electronically connected to pharmacy control computer209, through hubs 215, 217 and patch panel 219. Additional hubs 221,223, 225 may be provided to electronically connect components of LAN 65to control computer 209. Computer terminals 227, 229 at order entrypoint 71 are electronically connected in any suitable manner to hostcomputer 67 as part of PIS 69.

Control computer 209 is also referred to as a “controller” because ofits role in controlling the pharmacy workflow as described herein.However it should be noted that the term “controller” may include anysuitable device including computer 209 or may comprise the entire LAN 65within WMS 1.

An important advantage of the WMS 1 and its control architecture is thatthe system can be adapted to the unique needs of each pharmacy and canbe modified as the needs of the pharmacy change over time. For instance,a retail pharmacy will tend to serve customers who require thatmedications be dispensed into vials 59 or bottles 105. The prescriptionneeds of retail customers tend to be based on prescription medicationsrequired over extended periods of time, such as a week or a month.Apparatus such as the dispensers 91-97 and 159 are suitable for thispurpose as described above.

Hospitals or alternate site facilities, on the other hand, will tend torequire dosage unit packages, such as packages 108, which are segregatedinto separate cells separated by perforation lines and organized intothe package strip shown in FIG. 7D. Each of the packages 108 represent adosage unit to be taken by the patient, for example, on a particular dayor at particular times during the day. Each package includesmachine-readable indicia 110, such as the bar codes shown, whichidentify all information necessary to match the medication to aparticular patient. Other information, such as human-readableinformation identifying the patient name, medication type, instructionsfor taking the medication (such as the time of the day that themedication is to be taken) is typically printed on each package 108.

The package strip shown in FIG. 7D is of the type generated by an FDSbrand automated dispenser (not shown) available from AutoMedTechnologies. The FDS dispenser may easily be integrated into the WMS 1.WMS 1, therefore is easily adapted to serve the needs of the retail orhospital/alternate site pharmacy operator.

Moreover, if demand for medications at the retail and hospital/alternatesite pharmacies should increase over time, any number of any number ofadditional dispensers, for example FastFill or FDS dispensers, could beadded to the WMS 1 to address the changing needs of the pharmacyoperator.

Referring further to FIGS. 2-4, the technician work center 85 showntherein is provided as a work area for initiating fulfillment ofprescription orders and as a general work station. Technician workcenter 85 includes client computer 211 (or computers 211) and theassociated display and input apparatus 195-201 described above. While aseparate technician work center 85 is highly desirable, it should benoted that the function of center 85 could be performed at any clientcomputer within LAN 65.

A sequenced prescription order is presented to the pharmacist 241 orfilling technician 247 at the technician center 85 to initiatefulfillment. Specifically, the sequence in which the prescriptions areto be fulfilled is presented on video display 195 associated withtechnician center computer 211. It is highly preferred that theprescription sequence is also presented in the form of a “sequencesheet” 269 which is a paper record of the sequenced prescriptions shownon the display 195. The sequence sheet is printed before fulfillment ofthe prescription order and may be carried by the pharmacist 241 orfilling technician 247 as she walks to the fulfillment centers 73-79designated for fulfillment of the order. Sequence sheet 269 ispreferably in the form of a tote bag into which each prescription isplaced after fulfillment.

Sequence sheet 269, while highly preferred, is not required as WMS 1 mayoperate in a “paperless” mode. In the paperless mode, the sequencedorders are presented on display 195 at technician center 85 and on thedisplays 195 of each fulfillment center 73-79 accessed to obtainmedications required by the prescription order. The pharmacist 241 orfilling technician 247 merely follows the workflow path as directed bythe arranged text and icon storage location information 313, 315.

WMS 1 may be set in an automatic “automode” or in an “on-demand” modeusing the mode selection control 509 provided on set up set up screen510 (FIG. 30) presented on display 195 at technician center 85 orvalidation point 81. If the program is in automode then prescriptionorders are placed in a FIFO queue associated with the prescription orderdatabase 507 for fulfillment one after the other. The pharmacist 241 orfilling technician 247 merely fulfills each prescription order in thesequence in which the prescription orders are presented to him by thequeue. Therefore, WMS 1 advantageously reduces the need for humandecision making in the order fulfillment process reducing potentialerrors and minimizing the cost function.

If on-demand mode is selected, the prescription orders are manuallyselected for fulfillment by the pharmacist 241 or filling technician 247in the manner described below with respect to the method. Again, WMS 1provides easily understood direction to the pharmacy personnel withrespect to the most efficient manner of prescription order fulfillment.

Both the automode and on-demand mode may be modified by designation ofthe customer as a “waiter,” meaning that the customer is waiting to pickup the medication. In such an instance, control computer 209automatically places the prescription order for the waiting customer atthe head of the list of pending orders. This modification occursirrespective of whether automode or on-demand mode is selected. Further,the status of the prescription order is indicated to be that for a“waiter” as shown in FIGS. 10-11, 22-24 and 28 to alert the pharmacist241 or filling technician 247 as to the status of the prescriptionorder.

Typically, the status of the customer as a waiter is determined at thetime the prescription order is placed for fulfillment at order entrypoint 71 and is part of the prescription order data supplied by PIS 69to control computer 209. However, the status of the prescription ordermay be modified in WMS 1 by selecting priority button 329 and thenmodifying the status of the pending prescription order on a separate setup screen (not shown) by designating the prescription order as being fora waiter or as non-waiter. The ability to modify the status of theprescription order based on whether the customer is waiting permits thepharmacist 241 or filling technician 247 to immediately respond to theneeds of the customer, thereby better serving the customer.

A holding area 231 at validation point 81 may be provided to holdprescription orders after fulfillment but before validation. A work area233 and adjacent wash basin 235 may be provided as an area forpreparation and mixing of medications. A photocopy machine 237 mayoptionally be provided as may a facsimile machine 239 to assist thepharmacy personnel in performing their duties.

Validation point 81 is a work area within pharmacy 5, 7 at which apharmacist 241 validates the prescription orders. Validation point 85includes a client computer 213 the associated display 195 and keyboard,scanner, mouse and touch screen input apparatus 197-201 described abovewith respect to the other client computers 187-193 and technician centercomputer 211. The function of technician center 85 may be performed atvalidation point 81. The function of validation point 81 within WMS 1 isdescribed in detail below.

Order entry point 71 is a work area within pharmacy 5, 7 at which orderinformation is accepted by clerk 253. A customer (e.g., 257 or 259)provides a written prescription to clerk 253 together with any otherinformation required to initiate fulfillment of the prescription order.The information provided by the customer 257 will typically include thecustomer's name and address. The written prescription order provided bythe customer 257 to the data entry clerk 253 includes the physician'sname and, for each prescription within the prescription order, providesthe type of medication prescribed, the medication dosage and quantity,the date prescribed, the physician's instructions to the customer, thenumber of refills allowed and whether a generic version of themedication may be substituted. Clerk 253 also obtains information fromcustomer 257 with respect to his insurance coverage, co-payments and anyother pertinent information relating to payment for the prescriptionorder.

The prescription order information can be provided through directinteraction with customers or may be provided to clerk 253 viatelephonic communication with a physician. Prescription order refillinformation may be provided to clerk 253 through any suitable meansincluding via e-mail or computer interactive telephone communicationalso known as “IVR”.

Computer terminals 227, 229 at order entry point 71 are provided toenter the prescription order information into the host computer 67 towhich the terminals 227, 229 are electronically connected. (Terminals227, 229 are identical and for purposes of brevity only terminal 227will be discussed). Terminal 227 includes a video display 195 andkeyboard, scanner, mouse and touch screen input apparatus 197-201.Typically, a window is provided on display 195 which includes data entryfields provided to prompt clerk 253 with respect to the information tobe supplied by customer 257.

As described herein, PIS 69 resides on host computer 67 and includes thesoftware program which is used to process a prescription order beforerelease of the order for fulfillment by pharmacy 5, 7. It should benoted that in terms of prescription fulfillment process, what isrequired is a prescription which has been approved for fulfillment.Thus, the PIS 69 can be something as extensive as a nationwide networkof interconnected pharmacies or something as minimal as an order entrystation.

The prescription order information entered into host computer 67 is thenadjudicated by PIS 69. Adjudication involves processing the prescriptionorder to determine that the prescription order should be fulfilled andto determine whether any special processing is required. For example,insurance and co-payment information is typically confirmed. Thecustomer's medical records may be searched to determine whether thereare potential adverse drug interactions potentially at issue.

If the prescription order is compliant with the adjudication processthen the prescription order is sent by the PIS 69 to the controlcomputer 209 and into a prescription order database 507, preferablylocated on control computer 209. As described below in connection withthe method, WMS 1 conducts a review of the received prescription orderto determine whether the data is in the proper format and sequence andto determine whether the prescription order can be fulfilled by WMS 1.The adjudicated order is then available for subsequent processing at thetechnician center 85, fulfillment centers 73-79 and validation point 81.The signal representing the adjudicated order cleared for fulfillmentconsists of data in any suitable structure and format.

Pick up point 83 is an area in pharmacy 5, 7 where sales clerk 255processes the prescription order and provides the fulfilled order to thecustomer, health care provider or other authorized person. Pick up point83 is configured to meet the needs of the particular pharmacy.Pharmacies 5, 7 include computer terminals 275, 277 to process financialand customer information entered by sales clerk 255. Terminals 275, 277may interface with PIS 69. Will call area 89 is a storage location forfulfilled orders awaiting processing at pick up point 83. Eachprescription order at will call area 89 is held within a bin or shelf(not shown) organized by any suitable means, such as by the alphabeticalorder of the customer's surname. In place of a bin, the prescriptionorders may simply be held in the bag form sequence sheet for delivery tothe customer.

Pharmacies 5, 7 are staffed by pharmacy personnel including at least oneregistered pharmacist 241, 243, 245 one or more filling technicians 247,249, 251, an order entry clerk 253 and sales clerk 255. Pharmacists241-245 are capable of processing all aspects of prescription orderfulfillment including the provision of advice and information and theimportant order validation step described in detail below and requiredbefore release of the prescription order to the customer 257, 259, 261,263 and 265. The filling technicians 247-251 are responsible forobtaining the proper quantity and type of medications and products fromthe storage locations at fulfillment centers 73-79 for fulfillment ofthe prescription orders. The filling technicians 247-251 are also ableto perform order entry, inventory replenishment and the tasks of clerk253. Filling technicians 247-251 are typically able to provide advice tocustomers 257-265. However, filling technicians 247-251 are notauthorized to validate prescriptions or prescription orders, as onlypharmacists 241-245 are authorized to perform this task. Order entryclerk 253 is responsible for order entry at point 71 and is authorizedto perform the sales clerk's 255 tasks. Sales clerk 255 is authorized toprocess sales transactions at pick-up point 83.

Residing on control computer 209 is a software program 260 whichincludes pre-programmed instructions written to optimize the managementof the pharmacy workflow, including the coordination of all mechanicaland human resources of the pharmacy 5, 7 as described herein. Program260 has access to a medication inventory database 513 adapted todescribe the medications stored at each storage location associated withthe fulfillment centers 73-79, including all non-automated and, ifprovided, automated dispensing devices 91-97, 151, 159. The medicationinventory database 513 includes a complete description of eachmedication comprising the inventory. The description includes anysuitable parameters selected by the operator such as the medicationname, an identification number assigned to each medication, a stockimage, NDC number, type of packaging, if any, and inventory quantity.The precise storage location is also associated with each medication.For example, the storage location may be a specified cassette within anautomated dispenser (e.g., dispenser 91) or a row and shelf location ofa static storage shelf (e.g. locations 121, 122, 183).

Program 260 further includes a prescription order database 507 adaptedto store the prescription orders received from the PIS 69. Program 260includes programmed instructions adapted to minimize the cost functionassociated with fulfillment of the prescription orders stored in theprescription order database. The programmed instructions enable: (1) foreach prescription within the prescription order, selection of themedication storage location from which to obtain the medication requiredto fulfill the prescription; and (2) for each prescription order,determination of a prescription sequence corresponding to the sequencein which each prescription is fulfilled, first to last, within theprescription order. This optimization process and the various othersteps carried out by program 260 to direct the workflow of the pharmacy5, 7 are outlined in the method of operation described below.

As mentioned in the background section, a simple cost function to beminimized by program 260 may be the total time to fulfill a prescriptionorder or the total spacial distance traveled by pharmacy personnel inorder to fill a prescription order. For example, for each orderconsisting of more than one prescription, the optimization process whichis undertaken determines the sequence by which the individualprescriptions in the order are to be filled in order to minimize thetotal length of time required to fulfill the order. This determinationcan depend on more than the distance that must be traveled to obtaineach prescription, but also can include the time and cost required tocount (e.g., manual counting versus automated counting versusprepackaged). Thus, for medications which may be stored in more than oneform (e.g., prepackaged and bulk), the optimization process alsoincludes the selection of which location from which to obtain suchprescription medications in order to obtain the least expensive form ofthe medication, thereby minimizing the cost function.

In addition to total time or total distance traveled, other costfunctions can be utilized in order to achieve certain desired optimumperformance. For example, the sequence of a particular order and theselection of the locations from which medications are obtained can alsobe influenced by orders which are filled immediately prior to orimmediately following the filling of such particular order. This is ofcourse relevant to situations in which several prescription fillingtechnicians 247-251 are working at the same time in a pharmacy 5, 7. Forexample, if a bulk-form medication dispensing location (e.g., 91, 93) isbeing used to fill one or more prescriptions, the optimization processmay modify a sequence to “work around” such bulk dispensing or maydirect the technician 247 to obtain a medication from an alternatelocation. In such a case, the cost function being minimized may be amore complex function of time, taking into account how filling times areaffected by “neighboring” prescription orders. Alternatively, the costfunction may be a combination of total time and a term or terms whichpenalize conflicts which may occur at storage locations. Note that witha cost function that takes into account “neighboring” orders,performance benefits are possible even with orders containing only oneprescription if the pharmacy inventory stores some medications in morethan one storage location.

Numerous other cost functions can be constructed to optimize theperformance of WMS 1 by either penalizing or rewarding certain events orvariables involved in the prescription fulfillment process. For example,in addition to time, distance traveled, and avoidance of simultaneousfilling at the same location, the actual dollar cost of the medicationto the pharmacy may be taken into account as well as the utilization ofpersonnel, the need for inventory replenishment, and the special needsof the customer. Depending on the construction of the particular costfunction chosen, the pre-programmed instructions would include all ofthe operational parameters and descriptive data required to evaluatesuch cost function. For example, in cases in which the filling times areused in the evaluation of total time, specific operational data onfilling times would be included in the pre-programmed instructions ofprogram 260.

The preprogrammed instructions of program 260 for selecting themedication storage location and for sequencing will most likely residein code on the control computer 209. However, it is also possible that aportion of the program 260 could suitably be on other networkedcomputers, for example a technician work center computer 211 orvalidation point computer 213 in LAN 65.

Steps other than the optimization process are described in detail inconnection with the method. Such steps include tasks to facilitate theworkflow such as presentation (in human-readable form) of eachprescription order, the prescription sequence and the storage locationof the medication comprising each sequenced prescription before andafter the medications and products are retrieved and generating aprint_label command causing a networked label printer, for instanceprinter 205, to generate an adhesive backed label 279-285 once aprescription has been fulfilled. The print_label command prompts thelabel printer (e.g., label printer 205) to generate prescriptioninformation 301, 309, 311, 316 and machine-readable indicia 278 forapplication to each label 279-285 for each sequenced prescription. Thelabel 279-285 may then be applied to the container 57, 105 orpre-packaged article 153.

Method of Optimized Management of Pharmacy Workflow

The inventive system and method will now be further described,particularly with respect to the flow diagram of FIGS. 9A-9D and thescreen display images of FIGS. 10-30. The method is explained in thecontext of fulfillment of a hypothetical prescription order for afictional person named Tom Gibson at pharmacy 5. The four prescriptionscomprising the hypothetical prescription order consist of “medications”in the form of candy or antacid rather than actual prescriptionmedications or articles. It is to be understood that any medication orarticle stocked in the medication inventory may be dispensed accordingto the system and method. The flow diagram of FIGS. 9A-9D uses the terms“customer” and “patient” interchangeably as the WMS 1 may be used forany person requiring fulfillment of a prescription order from apharmacy.

Referring then to FIG. 9A, the first two functional boxes of the flowchart are functions which take place within PIS 63 associated with hostcomputer 67. Steps 501, 503 indicate the entry and adjudication of theprescription order. The order is received in any suitable form,typically at order entry point 71. The prescription order may, forexample, be received in the form of a paper prescription, in electronicform or through IVR. The prescription order is adjudicated by means ofthe PIS 63 as described above.

All of the remaining steps to be described in FIGS. 9A-D representfunctions carried out within the inventive WMS 1 in conjunction withcontrol computer 209 and LAN 65 (FIG. 5) as represented by thedemarcation lines in FIGS. 5 and 9A. In step 505, WMS 1 receives theadjudicated prescription order record from PIS 69 and the prescriptionorder is entered into the prescription order database 507, preferablyresiding on control computer 209.

WMS 1 is set on one of two modes of prescription order fulfillment in asetup process (not modeled in the flow chart). The first mode is theautomatic “automode” in which the prescription orders are automaticallyfilled in a FIFO manner. The second mode is an “on-demand” mode whichallows the pharmacist 241 or filling technician 247 to fulfill aprescription order immediately by manual selection of the specificprescription order presented on a display, preferably display 195 attechnician work center 85. The ranking of prescription orders in WMS 1may be modified based on whether the customer or patient is waiting forthe medication as discussed elsewhere herein. The screen display imagesshown in FIGS. 10-28 represent WMS 1 processing the exemplaryprescription order in the on-demand mode. Selection of the mode is madeby the pharmacist 241 by selecting the appropriate setting 509 on set upscreen 510 shown in FIG. 30.

Step 511 represents a check of the medication inventory database 513 toverify that WMS 1 is capable of fulfilling a particular prescription.Step 515 indicates that a negative response to step 511 has occurred andthe pharmacist 241 or filling technician 247 is so informed. Step 515reflects that a message (not shown) may be presented on display 195 attechnician station 85 indicating that the medication could not be found.Specifically, the negative response step 515 would be triggered if thepharmacy 5 did not stock the type of medication required by theprescription order.

In step 517, WMS 1 determines that an optimization process is requiredif the prescription order contains more than one prescription. If theprescription order contains a single prescription, WMS 1 skips forwardto step 523 discussed below. There is no minimization of any costfunction which does not takes into account “neighboring” prescriptionorders when there is only one prescription in the prescription order.

If the prescription order includes multiple prescriptions, then WMS 1commences step 519. In step 519, WMS 1 searches medication inventorydatabase 513 and all applicable operational data, using all of the datawhich describes the prescription and the inventory, including thestorage location of each medication, the quantity in inventory, thequantity required, the expiration dates, operational parameters andpreassigned priorities. The search of step 519 is further based on thepharmacy layout (e.g., FIGS. 2-4) and the current system setup.

WMS 1 carries out the optimization process of the invention in steps 519and 521. As described above, the optimization process results in theselection of the medication storage locations from which each medicationwill be obtained and the sequence in which fulfillment of theprescriptions comprising the prescription order will occur. Minimizationof the cost function is the objective of the optimization steps 519,521.

In step 523, the optimized prescription orders are displayed, preferablyon display 195 at technician work center 85. The location from whicheach medication will be obtained is presented. The prescriptions 307comprising the prescription order 305 are arranged in the sequence inwhich the prescriptions are to be fulfilled in order to minimize thecost function. Note that each order displayed has already been optimizedaccording to steps 519-521.

FIGS. 10-11 show a series of exemplary screen image displays generatedby WMS 1 on display 195 according to step 523. While it is preferredthat step 523 take place at technician station 85, the step could takeplace using any video display electronically connected to LAN 65.Referring first to FIG. 10, that figure shows a queue of pendingprescription orders organized by customer name and presented by WMS 1according to step 523. The prescription order for Tom Gibson is one ofthe pending prescription orders in the queue. Mr. Gibson's name 301 islisted in the first row 303 of the prescription order 305 under thecolumn for Patient/Rx. In the column for PickUp Time/Medication, Mr.Gibson is indicated to be waiting for the prescription order as of 12:00a.m. on a Tuesday which is the 28^(th) day of the month.

Each prescription 307 comprising order 305 is listed in a separate row303 beneath Mr. Gibson's name. The prescriptions comprising theprescription order have been placed in the optimized sequence generatedin steps 519, 521. In the example shown, computer 209 has determinedthat the order is most efficaciously fulfilled by filling first from theapparatus at fulfillment center 73 followed by fulfillment atfulfillment centers 79 and 75, an example of routing the work flowaround a center 75 that is busy fulfilling another pending order. Thecollection of prescriptions arranged in the optimal sequence is referredto herein as a “prescription sequence.” Each prescription 307 includes aprescription number 309, a description of the medication inhuman-readable form 311, identification of the medication storagelocation of the medication by address 313 and icon 315 and themedication count 316. A stock image 318 of each medication correspondingto each prescription is provided.

The medication storage address 313 includes a text description of theexact cassette, shelf or other storage location where the medication isstored. For example, the TIC TACS for the first prescription are locatedin FastFill-Cassette #2 while the CALTRATE 600 Plus of the thirdprescription is located at Shelf-3C11. The icon 315 corresponds to oneof the fulfillment centers 73, 75, 79 provided at pharmacy 5. Forexample, the icon 315 address corresponding to the first and secondprescriptions in Mr. Gibson's order corresponds to fulfillment center 73for dispensers 91-97, while the icons associated with the third andfourth prescriptions correspond, respectively, to fulfillment centers79, 75 for storage shelf units 163, 165 and dispenser 151. Theinformation associated with each prescription order is not limiting andmay be tailored to meet the needs of the particular pharmacy operator.

As shown in FIGS. 10 and 11, pharmacist 241 or filling technician 247selects Mr. Gibson's prescription order for fulfillment by touching therow 303 associated with Mr. Gibson's name followed by touching “Process”button 317 causing row 303 and the associated process box 319 to darkenin color indicating the selection. Mr. Gibson's order may be located byscrolling up or down using touch arrows 321 or by searching for thecustomer name using a data entry field (not shown) presented on display195 and accessed by touching the “Check Order” or “Find Manually”buttons 323, 325. Other optional buttons may be provided including an“Active Order” button 327 which causes WMS 1 to present a list of allpending prescription orders, a “Priority” button 329 which permits thepharmacist 241 or technician 247 to prioritize pending prescriptionorders for fulfillment (e.g., to designate a customer as a “waiter”), a“Setup” button 331 which permits access to setup screens (FIGS. 29, 30)to change the WMS settings, a “Reprint Menu” button 333 and a “Cancel”button 335 which cancels an action.

Returning to the method, in step 525 selection of a particular displayedprescription order (i.e., the order for Tom Gibson) causes WMS 1 todistribute the prescriptions to the selected medication storagelocations in fulfillment centers 73, 75 and 79. Note that in automode,the distribution of prescriptions to the selected locations occurs inadvance of the pharmacist preselecting a particular prescription order.

Referring next to FIG. 9C, fulfillment of the selected prescriptionorder may occur in a paperless mode (steps 527-535) or in a modeutilizing a sequence sheet 269 (steps 537-545).

Referring first to the mode utilizing the sequence sheet 269, step 537shows that a sequence sheet 269 (FIG. 8) is printed by printer 203connected to LAN 65 and preferably controlled by control computer 209.Sequence sheet 269 is preferably a bag printed on one side by printer209. It is intended that the sequence sheet 269 is carried by pharmacist241 or filling technician 247 about the pharmacy 5 during collection ofthe medications pertaining to the prescription order. Sequence sheet 269in effect acts as a “map” directing the pharmacist 241 or fillingtechnician 247 along the most efficient path for fulfillment of theprescription order. The preferred bag-form of the sequence sheet 269serves as a tote holding the fulfilled prescriptions during the processof prescription order fulfillment.

The prescription sequence is presented on sequence sheet 269 in the samearrangement as on the images displayed on the video display of step 523.(FIGS. 10-11). In addition to displaying all of the information shown onthe video display 195 (FIGS. 10-11), sequence sheet 269 also includesmachine-readable indicia 271, such as a bar code which corresponds toeach prescription. Customer name 301, prescription number 309,prescription type 311 and address 313, 315 information for the order 305may be provided. Additional information or instructions 273 may beprinted on sequence sheet 269, including compounding instructions (e.g.,“add water”), information about the medication packaging or speciallocation information, such as storage in a refrigerator.

The sequence sheet 269 may be adapted for use as a “consulting” tool byincluding detailed information about each prescription in the order. Forexample, the sequence sheet could include text adjacent eachprescription 307 with detailed instructions for taking the medication,such as the time of day the medication should be taken. Other detailedinformation might include information about potential side effects ordrug interaction information. All of the prescriptions comprising theprescription order may be placed in the bag-form sequence sheet 269 andthe entire bag could be provided to the customer at pick up point 83.Thus, the sequence sheet 269 would serve to package the prescriptionorder and provide the customer with useful information about theprescription order.

Also according to step 537, pharmacist 241 or filling technician 247walks to the fulfillment center 73 associated with the storage locationof the first among prescriptions 307 of the prescription order 305. Inthe prescription order for Mr. Gibson, the first and secondprescriptions are to be fulfilled, respectively, from bulk-formmedication dispensers 91 and 95, both of which are at fulfillment center73 and are controlled by the same client computer 187 and display 195.As shown in FIG. 12, display 195 located adjacent dispenser 91 haspresented thereon the two prescriptions to be dispensed, respectively,from bulk-form dispensers 91, 95. For purposes of consistency, theinformation for each prescription presented on display 195 atfulfillment center 73 corresponds to the information presented on thedisplay of step 523 (FIGS. 10-11) and on sequence sheet 269. The displayof FIG. 12 further provides container icon 314 directing the pharmacist241 or filling technician 247 to select a particular type of containerto hold the medication to be dispensed. In the example of FIG. 12, thecontainers pertaining to the first and second prescriptions are eachvials 59 having an 8 DRAM capacity. The NDC number and prescriptionquantity are also presented on the screen represented by FIG. 12.

In step 539, pharmacist 241 or filling technician 247 utilizes ahand-held scanner 197 electronically connected to LAN 65 to readsequence sheet 269 bar code 271 associated with the first prescription.Scanning of the bar code 271 triggers generation of an initiate_dispensesignal to control computer 209 which causes dispenser 91 to release themedication associated with the first prescription into a hopper or chute(not shown) within dispenser 91. The code 271 corresponds theprescription number 309 and is a unique identifier of the prescription307. Therefore, the code 271 essentially points to all of theinformation associated with the prescription 307 including, for example,customer and prescription order identification, and the type, strengthand quantity of medication to be dispensed. Control computer 209 (oranother computer within LAN 65) activates the appropriate medicationstorage location (e.g. a cassette such as cassette 99-103) withindispenser 91 based on information within the medication inventorydatabase 513 and meters the appropriate quantity into a hopper or chutein dispenser 91 in preparation for dispensing into vial 59.

In step 541, the empty vial 59 is placed under a spout 109, and themedication is dispensed into the vial 59. For the dispensers 91-97, theact of manually lifting a gate (not shown) near spout 109 triggers themedication_dispensed signal and causes the dispenser to dispense themedication into the vial 59. The medication_dispensed signal informscontrol computer 209 that the medication has been dispensed in theproper quantity. Typically, if the quantity is incorrect an error signalis generated to inform the pharmacist 241 or filling technician 247thereof. The aforementioned process will vary depending on the type ofautomated dispenser being utilized. For example, themedication_dispensed signal may occur without human intervention in thedispensing process.

In step 543, a print_label command is generated by control computer 209in response to this agreement between the initiate_dispense andmedication_dispensed signals. This process along with the controlledmanagement of the medication inventory ensures that the correctmedication at the correct quantity and strength is matched to thecorrect customer, thereby significantly reducing potential for error.The print_label command causes label printer 205 to generate a label 279corresponding to the first prescription and including the customer name301 and prescription number 309, the type 311 and quantity 316 of themedication, the physician who prescribed the medication, the fill dateand other information, such as the number of permitted refills. Label279 is adhesive-backed and is manually placed on vial 59 by pharmacist241 or filling technician 247. The vial 59 may then be placed in thebag-form sequence sheet 269.

According to step 545, steps 537-543 are repeated if the prescriptionorder includes more than one prescription. With respect to theprescription order for Mr. Gibson, FIG. 14 shows the state of display195 following dispensing of the first prescription but before dispensingthe second prescription from bulk-form dispenser 95. The prescriptioninformation for the first prescription is deleted because thatprescription has been fulfilled. Steps 537-543 are then repeated asdescribed above resulting in dispensing of the medication for the secondprescription from dispenser 95 through a spout (such as spout 109) andinto a vial, such as vial 59. Label 281 is printed by printer 205 forattachment to vial 59.

The third prescription in Mr. Gibson's order is to be filled atfulfillment center 79 utilizing manually-accessed shelves 163, 165 asindicated by the storage location information 313 and icon 315 on thesequence sheet 269 and stock image information 318 on FIGS. 10-11 and16. FIG. 16 is the image presented by WMS 1 on shared display 195serving fulfillment centers 75, 79 adjacent to shelves 163, 165. FIG. 16shows the single prescription 307 assigned for fulfillment at shelves163, 165. FIG. 2A shows the storage location code 183 and cell 173 forcontainer 179 which holds the CALTRATE 600 called for by theprescription order 305.

Steps 537-543 are repeated as described above resulting in manualselection of container 179 holding the CALTRATE 600 product. Fulfillmentof the third prescription differs only from steps 537-543 in that themedication_dispensed signal is generated by reading (with scanner 197) abar code (not shown) on the container 179 for the CALTRATE 600 product.Additionally, label 283 is printed for attachment to the container 179for the CALTRATE 600 product. As shown in FIG. 18, a message box 337 maybe presented on display 195 at center 79 presenting a stock image 339and permitting verification of the manually-picked product. Selection ofthe “Ok” button 341 following visual comparison of the stock image 318and medication completes the process of fulfillment of the thirdprescription.

The fourth prescription in Mr. Gibson's order is to be filled at thefulfillment center 75 automated pre-packaged article dispenser 151 asshown by the storage icon 315 on the sequence sheet 269 and iconinformation 315 on FIGS. 10-11. FIG. 19 is the image presented by WMS 1on display 195 located adjacent to center 75 and dispenser 151.

Steps 537-543 are repeated as described above resulting in dispenser 151dropping the package (such as package 153) containing the CERTS productinto bin 155. Like fulfillment of the third prescription, themedication_dispensed signal is generated by reading (with scanner 197) abar code (e.g., bar code 154) on the package (not shown) for the CERTSproduct. Additionally, label 285 is printed for attachment to thepre-packaged container for the CERTS product. All containers for thefour prescriptions may then be forwarded to the pharmacist forvalidation as described below.

The paperless system of steps 527-535 will now be described with respectto FIG. 9C. According to step 527, the pharmacist 241 or technician 247walks to the center 73 associated with the first prescription order asshown in FIGS. 10-11. No sequence sheet 269 is provided or needed in thepaperless system. The pharmacist 241 or filling technician 247 thentouches the display 195 touch screen 201 adjacent the customer's name301 causing step 525, the distribution step, to occur (FIG. 11).

In step 529 of the paperless system, a prompt 343 is generated afterselection of the desired prescription as shown in FIGS. 13, 15, 17 and20. Selection of the “Yes” or “Ok” button 345 confirms correct selectionof the prescription and generates the initiate_dispense signal. Steps531-533 of the paperless system are identical to steps 541 and 543 ofthe mode using the sequence sheet and the description of such steps foreach of the four prescriptions comprising the Gibson prescription orderis incorporated herein by reference. All of the fulfilled prescriptionsare then forwarded to the pharmacist for validation as described below.

Validation of the prescription order 305 is represented by steps 549-555on FIG. 9D. Validation is the review process wherein each prescriptioncomprising the prescription order is inspected to ensure that theprescription order has been fulfilled correctly and in accordance withthe prescription order. Validation includes, for example, confirmationthat the prescription order is matched to the correct customer,confirmation that all prescriptions within the prescription order havebeen fulfilled and confirmation that the correct medication has beenmatched to each prescription. Validation may be accomplished throughprogram 260 or through a separate software program residing, forexample, on validation point computer 213 or on control computer 209.

In step 549, the fulfilled prescription order is provided to thepharmacist 241 for validation at validation point 81. Pharmacist 241selects the prescription order 305 to be validated from the queue ofpending prescription orders presented on display 195 by WMS 1 as shownin FIG. 22. In the example, pharmacist 241 selects Mr. Gibson'sprescription order 305 for validation by touching the row 303 associatedwith Mr. Gibson's name. Mr. Gibson's order may be located by scrollingup or down using touch arrows 321 or by searching for the customer nameas described above. As shown in FIG. 23, WMS 1 then displays Mr.Gibson's prescription order for validation, removing all other pendingprescription orders from view on display 195.

As can be seen on FIG. 23, Mr. Gibson's prescription order includes thefour prescriptions 307 in the optimized prescription sequence for thatprescription order 305. Each prescription 307 includes the sameinformation as shown in FIG. 10 including the prescription number 309,description of the medication type 311, identification of the medicationstorage location by address 313 and icon 315 and the medication count316 for each prescription 307. A stock image 318 of each medication isprovided.

The package icons 339 associated with each prescription indicate thateach prescription has been properly dispensed by the automateddispensers and that manually-selected prescriptions have been duly scanverified by a pharmacist 241 or filling technician 247 to generate themedication_dispensed signal. FIG. 28 represents the state of the orderif the prescriptions are not verified as being correctly dispensed. Theabsence of the package icon 339 for each prescription indicates thatheightened scrutiny of the prescription order is warranted.

In step 551, the pharmacist validates the first prescription in theprescription order. The pharmacist 241 selects the prescription to bevalidated by (1) touching row 303 associated with the prescription 307,(2) by scanning the bar code 278 on label 279 with a scanner 197 or (3)by scanning the prescription bar code 271 on the sequence sheet 269 withreader 197. Selection of the prescription generates a first validationsignal received by control computer 209 or another computer in LAN 65.

Pharmacist 241 then visually inspects the dispensed medication andcompares the medication to the stock image 318 presented by WMS 1 ondisplay 195. In the case of medications dispensed by a fully automateddispenser 159, the pharmacist 241 would compare the digital image of themedication captured by the dispenser 159 to the stock image 318. Asshown in FIGS. 24-27, the stock image 318 can be enlarged by touchingthe touch screen 201 on stock image 318. The enlarged image 318 assiststhe pharmacist 241 with the inspection and may be presented togetherwith the customer name, NDC number and medication description. If theprescription has been filled properly, the pharmacist 241 scans the barcode 278 on the label 279 with scanner 197 generating a secondvalidation signal received by control computer 209 or another computerin LAN 65. If the control computer 209 (or other LAN 65 computer)determines that the first and second validation signals are in agreementthen the validated prescription is available for release to thecustomer.

According to step 553, the validation process is repeated for eachprescription in the prescription order. The entire prescription order isreleased once the control computer 209, or other LAN 65 computer, hasreceived agreement on the validation signals for each prescription inthe prescription order. The check marks 347 next to each prescription307 signify that the prescription has been validated.

Validation is completed according to step 555 when the pharmacist 241places all prescriptions in a bag or other container (not shown) at thepick up point 83 for pick up by the customer 263. Sequence sheet 269 maybe used for this purpose.

An optional control may be imposed on validation by requiring entry of apersonal identification code indicating authority to validate theprescription order. The identification code may be typed into a dataentry field or may be a code on a pharmacist's identification badgewhich is read by scanner 197 before commencement of validation. WMS 1denies access to validation for unauthorized pharmacy personnel.

A replenishment process may be provided in the context of the pharmacywith optimized workflow and such replenishment process is embodied bysteps 557-563. According to step 557, program 260 updates the quantitiesin inventory as medications and other articles are dispensed frommedication storage locations. Also in step 557, WMS 1 automaticallycontacts the vendor of the medication or article which has reached apredetermined level of inventory depletion. WMS 1 places an order forreplenishment of the inventory with the vendor.

In step 559, the replenishment order is received, processed andfulfilled by the vendor. As part of this step, the vendor sends theordered medication or article to the pharmacy. Preferably, themedication or product is in a container (not shown) with amachine-readable code (e.g., a bar code) corresponding to the product,including product identification and lot number, a product quantity andan expiration date.

In step 561, a filling technician 247 scans the code on the productreceived from the vendor and is directed to the appropriate medicationstorage location in WMS 1. Filling technician 247 may use a hand heldcomputer 349 shown in FIG. 31 for this purpose. Hand held computer 349includes a machine-readable code scanner 351 and interfaces with LAN 65and program 260. (The filling technician 241 may optionally initiatereplenishment by entering his personal identification code into computer349 thereby enabling the WMS 1 to identify the person responsible forthe replenishment.) Scanned information is entered into computer 349 andinformation from a database on the computer 349 is presented on thecomputer display screen 353 providing information directing the fillingtechnician 247 to the medication storage location at which themedication or product is to be stored. The storage location may, forexample, be a cassette 101 in dispenser 91, a storage shelf 163 or alocation in an automated prepackaged-form medication dispenser 151.

According to step 563, the filling technician 247 then scans amachine-readable code (e.g., code 122, 124, 184) at the designatedmedication storage location (e.g., cell 173, or shelf 115 in FIG. 3D)and on the product container, preferably using hand held computer 349.If there is agreement between the identified medication and the scannedstorage location, the filling technician receives a prompt from computer349 directing him to replenish the medication.

The filling technician 247 then places the medication or product intothe designated storage location completing the replenishment process.The filling technician 247 could also manually enter information aboutthe restocked medication into computer 349. Such manually-enteredinformation could include the product identification and lot number, theprecise product quantity placed into inventory and the expiration date.

The information collected on computer 349 is then supplied from computer349 to program 260 to increment the inventory into the WMS 1 and toprovide current medication inventory information to WMS 1, including theexact storage location where the medication is stored and the quantityof medication at that location. The availability of accurate and currentmedication inventory information to WMS 1 greatly facilitates accuratesequencing of the prescriptions during the prescription orderfulfillment process described above. The replenishment process imposeslevels of security and control ensuring that the medication inventorydatabase 513 and the actual medication inventory are in completeagreement.

The replenishment process described herein permits the pharmacy operatorto not only replenish the inventory but to closely monitor the conditionof the medication inventory. For example, the same medication may bestored at different medication storage locations within WMS 1. Suchmedications may have different expiration dates. By tracking theexpiration dates of medication in the medication inventory and byselectively replenishing the older inventory it is possible to maintaina medication inventory including the most potent medications therebyimproving service to the customer.

Example and Data

In order to verify the advantages of the present invention, a simulationof pharmacy workflow was performed using a computer model of a typicalpartially-automated pharmacy layout, the number and type of prescriptionorders for a typical week, and a normal complement of pharmacypersonnel. The system simulated consisted of an AutoMed FastFill system,an AutoMed QuickFill Plus system, and several static storage shelves.

Comparison was made between this system with no workflow optimizationand the same system with the inventive optimization process used toselect the storage locations from which to obtain medications and todetermine the best sequence in which to fill the prescriptions withineach prescription order. The cost function chosen for the simulation wastotal time to fill prescription orders.

A one-week prescription load of 2205 prescriptions was simulated,including 309 multi-prescription orders with an average of 2.5prescriptions per multi-prescription order. The improvement achieved inthe simulation indicated that under these workload assumptions, therewas a 5.5% decrease in the average time required to fill an order.

Of the 309 multi-prescription orders, 219 consisted of two prescriptionsand 60 contained three prescriptions. In an order environment in which ahigher percentage of the orders are multi-prescription orders having ahigher average number of prescriptions per multi-prescription order, aneven higher benefit is expected. Further benefit is possible with a costfunction which takes into account “neighboring” orders since such a costfunction is designed to provide efficiency improvements for somepercentage of the single-prescription orders, depending on how many ofthe medications in the inventory have more than one storage locationfrom which they can be obtained.

While the principles of the invention have been shown and described inconnection with specific embodiments and steps, it is to be understoodthat such embodiments are by way of example and are not limiting.

1.-13. (canceled)
 14. A computerized method for filling a prescriptionorder, comprising: receiving by a control computer a prescription ordercomprising two or more medications, each medication stored at adifferent location; using the control computer to generate a sequence inwhich to gather the medications of the prescription order at thedifferent locations; and generating human-readable indicia of thesequence; wherein the control computer determines the sequence byminimizing a cost function associated with gathering the two or moremedications from the different locations for the fulfillment of theprescription order.
 15. The computerized method of claim 14 wherein thecost function includes at least one variable related to the distancerequired to be traveled between the different locations to fulfill theprescription order.
 16. The computerized method of claim 14 wherein thecost function includes variables related to the locations of medicationsassigned to other prescription orders that are co-pending with theprescription order.
 17. The computerized method of claim 14 wherein thecontrol computer is programmed to determine the sequence to decrease thetime needed to fill the prescription order.
 18. The computerized methodof claim 14, wherein the control computer is programmed to determine thesequence based upon the position of the different locations.
 19. Thecomputerized method of claim 14 wherein the human-readable indiciaincludes information identifying each of the two or more medications.20. The computerized method of claim 19 wherein the human-readableindicia includes information identifying the storage location of each ofthe two or more medications.
 21. The computerized method of claim 20wherein the information is printed on a tote bag configured to hold themedications of the prescription order.
 22. The computerized method ofclaim 14, further comprising: receiving a digital image of at least oneof the medications stored in a dispensing apparatus provided at one ofthe different locations, the digital image taken by a feature of thedispensing apparatus.
 23. The computerized method of claim 22, furthercomprising: displaying the digital image proximate to a display of astock image of the medication for comparison thereof.
 24. A method forfulfilling a prescription within a personnel-driven pharmacy, the methodcomprising: receiving by a control computer a prescription ordercomprising two or more medications, each medication stored at adifferent location within the pharmacy; generating a sequence in whichto retrieve the medications from the different locations with a controlcomputer, the control computer programmed to generate the sequence basedon workflow considerations; and generating human-readable indicia of thesequence, the human-readable indicia including indicia identifying eachof the two or more medications and including information identifying thestorage location of each of the two or more medications.
 25. The methodof claim 24 wherein the workflow considerations include the distancerequired to be traveled between the different locations to fulfill theprescription order within the pharmacy.
 26. The method of claim 24wherein the indicia identifying each of the two or more medicationsincludes at least one of a name of the medication and a stock image ofthe medication, wherein the information identifying the storage locationof each of the two or more medications includes an icon representativeof the location at which each medication is stored.
 27. The computerizedmethod of claim 26 wherein the sequence is printed on a tote bagconfigured to hold the medications of the prescription order.
 28. Acomputerized method for filling a prescription order within a pharmacy,the prescription order including at least two medications to beretrieved from separate storage locations within the pharmacy, themethod comprising: determining a sequence in which to gather themedications of the prescription order at the different locations withinthe pharmacy with a control computer, wherein the control computerdetermines the sequence based upon a cost function associated withgathering the two or more medications for the fulfillment of theprescription order; and generating human-readable indicia of thedetermined sequence.
 29. The computerized method of claim 28 wherein thecost function includes at least one variable related to the distancerequired to be traveled between the different locations to fulfill theprescription order.
 30. The computerized method of claim 28 wherein thecost function includes variables related to the locations of medicationsassigned to other prescription orders that are co-pending with theprescription order.
 31. A method for facilitating the efficient fillingof a prescription order within a pharmacy, the prescription orderincluding at least two medications to be retrieved from separate storagelocations within the pharmacy, the method comprising: programming acontrol computer to determine a sequence in which to gather themedications of the prescription order based upon a cost functionassociated with the gathering the two or more medications within thepharmacy; and programming a control computer to generate human-readableindicia of the determined sequence.
 32. The method of claim 31 whereinthe cost function includes at least one variable related to the distancerequired to be traveled between the different locations to fulfill theprescription order.
 33. The method of claim 31 wherein the cost functionincludes variables related to the locations of medications assigned toother prescription orders that are co-pending with the prescriptionorder.